This paper seeks to unpack the relationship between mobility and accessibility on the one hand, and rural healthcare delivery on the other, within the ambit of the sustainable livelihoods approach using four villagers in the Thaba Chweu municipality in Mpumalanga Province, South Africa as case studies. The main argument is that service delivery such as quality healthcare in rural South Africa is fraught with deep-rooted intractable challenges, many of which are to do with access problems emanating, in part, from the remoteness and spatial dispersion of rural communities. A variety of qualitative and quantitative instruments were employed to gather data to respond to the study hypotheses and research questions. The findings indicate a symbiotic relationship between the health-seeking behaviour of villagers and mobility and accessibility. In addition, rural healthcare delivery (particularly for the terminally ill), and by extension, the healthcare access burden appears to have significantly shifted from the formal healthcare system (especially with regard to emergency cases) onto the shoulders of home-based care practitioners. Unravelling and understanding mobility and access issues relating to both formal and informal rural healthcare delivery, is indeed a vital step to generating sustainable intervention options, as well as ensuring that the nexus between transport and healthcare is fully recognized and integrated into practical interventions.

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Paper presented at the 27th Annual Southern African Transport Conference 7 - 11 July 2008 "Partnership for research and progress in transportation", CSIR International Convention Centre, Pretoria, South Africa